Electrical impedance tomography reveals pathophysiology of neonatal pneumothorax during NAVA
Electrical impedance tomography reveals pathophysiology of neonatal pneumothorax during NAVA
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DOI：
10.1002/ccr3.2944
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发表时间：
2020-05-24
影响因子：
0.7
通讯作者：
Frerichs, Inez
中科院分区：
文献类型：
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作者：
Kallio, Merja;Rahtu, Marika;Frerichs, Inez
气胸是新生儿呼吸窘迫综合征（RDS）的潜在威胁生命的并发症。我们描述了一例张力性气胸，发生在神经调节通气辅助（NAVA）的早产儿患有RDS。该婴儿被纳入一项多中心研究，检查电阻抗断层扫描（EIT）在重症监护中的作用，因此使用这种成像方法对其进行持续监测。主治医生对EIT结果不知情，但线下分析显示EIT有可能澄清该并发症的潜在原因，在本例中，是异质性肺部疾病导致通气分布不均匀。在空气泄漏时，观察到患侧呼气末肺阻抗的瞬时增加。床边实时可用的EIT数据可以修改治疗决策。
Pneumothorax is a potentially life-threatening complication of neonatal respiratory distress syndrome (RDS). We describe a case of a tension pneumothorax that occurred during neurally adjusted ventilatory assist (NAVA) in a preterm infant suffering from RDS. The infant was included in a multicenter study examining the role of electrical impedance tomography (EIT) in intensive care and therefore continuously monitored with this imaging method. The attending physicians were blinded for EIT findings but offline analysis revealed the potential of EIT to clarify the underlying cause of this complication, which in this case was heterogeneous lung disease resulting in uneven ventilation distribution. Instantaneous increase in end-expiratory lung impedance on the affected side was observed at time of the air leak. Real-time bedside availability of EIT data could have modified the treatment decisions made.